Erythema multiforme - Multiformni Eritem
☆ U rezultatima Stiftung Warentest iz Njemačke za 2022., zadovoljstvo potrošača s ModelDermom bilo je samo malo niže nego s plaćenim konzultacijama o telemedicini.
Erythema multiforme minor ― Imajte na umu da središta lezija mogu blijedjeti.
Urtikarija se također može smatrati diferencijalnom dijagnozom.
References
Erythema multiforme (EM) je stanje u kojem se karakteristične mrlje poput mete pojavljuju na koži i sluznicama zbog imunoloških reakcija. Iako je često potaknuta virusnim infekcijama, osobito herpes simplex virusom (HSV) , ili određenim lijekovima, uzrok u mnogim slučajevima ostaje nepoznat. Liječenje akutnog EM-a usmjereno je na ublažavanje simptoma korištenjem krema koje sadrže steroide ili antihistaminike. Liječenje ponavljajućeg EM-a najučinkovitije je kada je prilagođeno svakom pacijentu. Početni pristupi uključuju i oralno i lokalno liječenje. To uključuje kortikosteroide i antivirusne lijekove. Lokalni tretmani sastoje se od jakih steroidnih krema i otopina za zahvaćene sluznice. Za pacijente koji ne reagiraju na antivirusne lijekove, opcije druge linije uključuju lijekove za supresiju imuniteta, antibiotike, antihelmintike i antimalarike.
Erythema multiforme (EM) is an immune-mediated condition that classically presents with discrete targetoid lesions and can involve both mucosal and cutaneous sites. While EM is typically preceded by viral infections, most notably herpes simplex virus (HSV), and certain medications, a large portion of cases are due to an unidentifiable cause. Treatment for acute EM is focused on relieving symptoms with topical steroids or antihistamines. Treatment for recurrent EM is most successful when tailored to individual patients. First line treatment for recurrent EM includes both systemic and topical therapies. Systemic therapies include corticosteroid therapy and antiviral prophylaxis. Topical therapies include high-potency corticosteroids, and antiseptic or anesthetic solutions for mucosal involvement. Second-line therapies for patients who do not respond to antiviral medications include immunosuppressive agents, antibiotics, anthelmintics, and antimalarials
Erythema multiforme (EM) is an immune-mediated condition that classically presents with discrete targetoid lesions and can involve both mucosal and cutaneous sites. While EM is typically preceded by viral infections, most notably herpes simplex virus (HSV), and certain medications, a large portion of cases are due to an unidentifiable cause. Treatment for acute EM is focused on relieving symptoms with topical steroids or antihistamines. Treatment for recurrent EM is most successful when tailored to individual patients. First line treatment for recurrent EM includes both systemic and topical therapies. Systemic therapies include corticosteroid therapy and antiviral prophylaxis. Topical therapies include high-potency corticosteroids, and antiseptic or anesthetic solutions for mucosal involvement. Second-line therapies for patients who do not respond to antiviral medications include immunosuppressive agents, antibiotics, anthelmintics, and antimalarials
U mnogim slučajevima, blagi erythema multiforme nestaje sam od sebe unutar 2 do 4 tjedna. Stevens-Johnsonov sindrom, teško stanje koje zahvaća sluznice, može trajati do 6 tjedana. Steroidi se obično ne preporučuju za blage slučajeve. Neizvjesno je treba li steroide koristiti za teški multiformni eritem budući da nema jasnih nalaza iz randomiziranih studija koji bi ukazivali kojoj bi djeci ovaj tretman bio od koristi.
In most cases, mild erythema multiforme is self-limited and resolves in 2 to 4 weeks. Stevens-Johnson syndrome is a serious disease that involves the mucous membranes and lasts up to 6 weeks. There is no indication for using steroids for the mild form. Use of steroids for erythema multiforme major is debatable because no randomized studies clearly indicate which children will benefit from this treatment.
In most cases, mild erythema multiforme is self-limited and resolves in 2 to 4 weeks. Stevens-Johnson syndrome is a serious disease that involves the mucous membranes and lasts up to 6 weeks. There is no indication for using steroids for the mild form. Use of steroids for erythema multiforme major is debatable because no randomized studies clearly indicate which children will benefit from this treatment.
Predstavljamo slučaj oralne erythema multiforme (EM) uzrokovane TMP/SMX , pokazujući tipične oralne i usne čireve bez kožnih lezija. Ovo naglašava potrebu da se razlikuje od drugih oralnih ulcerativnih poremećaja. Pacijent je primio simptomatsko liječenje i tablete prednizolona, što je dovelo do poboljšanja nakon prestanka terapije TMP/SMX.
We report a case of oral erythema multiforme (EM) secondary to TMP/SMX that presented with oral and lip ulcerations typical of EM without any skin lesions and highlights the importance of distinguishing them from other ulcerative disorders involving oral cavity. The patient was treated symptomatically and given tablet prednisolone. The condition improved with stoppage of TMP/SMX therapy.
We report a case of oral erythema multiforme (EM) secondary to TMP/SMX that presented with oral and lip ulcerations typical of EM without any skin lesions and highlights the importance of distinguishing them from other ulcerative disorders involving oral cavity. The patient was treated symptomatically and given tablet prednisolone. The condition improved with stoppage of TMP/SMX therapy.
Erythema multiforme je reakcija koja uključuje kožu, a ponekad i sluznicu, koju pokreće imunološki sustav. Tipično se očituje kao lezije slične meti, koje se mogu činiti izolirane, ponavljati se ili postojati. Ove lezije obično simetrično zahvaćaju ekstremitete, osobito njihove vanjske površine. Glavni uzroci uključuju infekcije poput herpes simplex virusa i Mycoplasma pneumoniae, kao i određene lijekove, imunizaciju i autoimune bolesti. Razlikovanje erythema multiforme od urtikarije ovisi o trajanju lezija; erythema multiforme lezije ostaju fiksirane najmanje sedam dana, dok urtikarijalne lezije često nestaju unutar jednog dana. Iako je sličan, ključno je razlikovati erythema multiforme od težeg Stevens-Johnsonovog sindroma, koji obično predstavlja raširene eritematozne ili purpurne mrlje s mjehurićima. Liječenje erythema multiforme uključuje simptomatsko olakšanje lokalnim steroidima ili antihistaminicima i rješavanje temeljnog uzroka. Za ponavljajuće slučajeve povezane s virusom herpes simplexa preporučuje se profilaktička antivirusna terapija. Teška zahvaćenost sluznice može zahtijevati hospitalizaciju radi intravenske primjene tekućine i nadoknade elektrolita.
Erythema multiforme is a reaction involving the skin and sometimes the mucosa, triggered by the immune system. Typically, it manifests as target-like lesions, which may appear isolated, recur, or persist. These lesions usually symmetrically affect the extremities, particularly their outer surfaces. The main causes include infections like herpes simplex virus and Mycoplasma pneumoniae, as well as certain medications, immunizations, and autoimmune diseases. Distinguishing erythema multiforme from urticaria relies on the duration of lesions; erythema multiforme lesions remain fixed for at least seven days, while urticarial lesions often vanish within a day. Although similar, it's crucial to differentiate erythema multiforme from the more severe Stevens-Johnson syndrome, which typically presents widespread erythematous or purpuric macules with blisters. Managing erythema multiforme involves symptomatic relief with topical steroids or antihistamines and addressing the underlying cause. For recurrent cases associated with herpes simplex virus, prophylactic antiviral therapy is recommended. Severe mucosal involvement may necessitate hospitalization for intravenous fluids and electrolyte replacement.
Erythema multiforme is a reaction involving the skin and sometimes the mucosa, triggered by the immune system. Typically, it manifests as target-like lesions, which may appear isolated, recur, or persist. These lesions usually symmetrically affect the extremities, particularly their outer surfaces. The main causes include infections like herpes simplex virus and Mycoplasma pneumoniae, as well as certain medications, immunizations, and autoimmune diseases. Distinguishing erythema multiforme from urticaria relies on the duration of lesions; erythema multiforme lesions remain fixed for at least seven days, while urticarial lesions often vanish within a day. Although similar, it's crucial to differentiate erythema multiforme from the more severe Stevens-Johnson syndrome, which typically presents widespread erythematous or purpuric macules with blisters. Managing erythema multiforme involves symptomatic relief with topical steroids or antihistamines and addressing the underlying cause. For recurrent cases associated with herpes simplex virus, prophylactic antiviral therapy is recommended. Severe mucosal involvement may necessitate hospitalization for intravenous fluids and electrolyte replacement.
Stanje varira od blagog, samoograničenog osipa do teškog, po život opasnog oblika poznatog kao erythema multiforme major koji zahvaća i sluznice. Invazija sluznice ili prisutnost bula važni su znakovi ozbiljnosti.
- Erythema multiforme minor: tipične mete ili uzdignute, edematozne papule raspoređene akralno
Blagi oblik obično se manifestira blagim svrbežom (ali svrbež može biti vrlo jak), ružičasto-crvenim mrljama, simetrično raspoređenim i počinju na ekstremitetima. Rezolucija osipa unutar 7-10 dana je norma u ovom obliku bolesti.
- Erythema multiforme major: tipične mete ili uzdignute, edematozne papule raspoređene akralno sa zahvaćanjem jedne ili više sluznica. Odvajanje epidermisa zahvaća manje od 10% ukupne površine tijela.
○ Liječenje ― OTC lijekovi
Ako je praćen groznicom (povišenom tjelesnom temperaturom), preporuča se što prije otići u bolnicu.
Sumnjive lijekove treba prekinuti. (npr. antibiotici, nesteroidni protuupalni lijekovi)
Oralni antihistaminici kao što su cetirizin i loratadin za svrbež.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]